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Editorial

Legislative malpractice

Chiropractors shouldn’t be ruling on young athletes’ concussions

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The Ohio legislature has ignored expert medical advice and put children at risk by opening the
door for chiropractors to independently clear young athletes to resume play after they’ve suffered
a concussion.

Elected officials last week tucked the provision into a wide-ranging education bill not open to
line-item veto by the governor.

This is a terrible idea.

Concussions are traumatic brain injuries. They require time to heal. Young people’s brains are
still developing. A second impact, whipping the brain around again, can cause a lot more
damage.

Chiropractors are experts at what they do, but that expertise does not extend to
concussions.

The General Assembly leapt over common sense and science in yielding to chiropractors, weakening
the state’s model law, which took effect last year. That law, the result of hours of expert
testimony and debate at the Statehouse, protected injured youths by giving physicians ultimate
authority over return-to-play decisions.

This new provision, having been killed before, was restored by the Senate into House Bill 487
and pushed through without testimony. It was a triumph of well-connected and high-priced lobbying
over the well-being of children. It comes even as the dangers of concussion are being highlighted
in collegiate and professional sports.

The legislature handed off to a committee the responsibility for determining minimum education
standards for those who can grant clearance. And it left undefined the guidelines that will be used
for clearing young athletes who have suffered a concussion. Three chiropractors and three doctors
will be named to this panel, which appears to be a backdoor way for chiropractors to be granted
authority to exceed their scope of practice.

The only way this can work is if the committee puts medical science ahead of politics. But this
seems unlikely, with half the panel made up of chiropractors who likely will be eager to expand the
reach of the chiropractic approach.

The provision also opens the door to any “licensed health-care professional” who might wish to
evaluate concussed athletes. The committee could grant return-to-play decisions to dental
hygienists, genetic counselors, psychologists, radiologist technicians and even dieticians, to name
a few.

It’s not hard to imagine a teenager eager to rejoin his or her team — or a parent dreaming of
college scholarships — shopping for someone to sign off. Or a parent or coach could be deceived
into thinking any of these medical professionals is an expert in evaluating concussions and
authorizing a child to resume play. While in medical school, doctors get more than 10,000 hours of
clinical experience treating patients, including those with traumatic head injuries. No other
training compares.

Those opposing this legislation include the Ohio State Medical Association, the Ohio Chapter of
the American Academy of Pediatrics, the Ohio Children’s Hospital Association, the Ohio Hospital
Association, the Ohio Chapter of the American College of Emergency Physicians, the Ohio Athletic
Trainers Association, the Ohio Osteopathic Association and the Academy of Medicine of Cleveland and
Northern Ohio. Also adding warnings are leading physicians from the Cleveland Clinic and Nationwide
Children’s Hospital.

By ignoring the best medical advice, the General Assembly endangers the health and safety of
Ohio’s children.